| Carriers (HCPCS), DMERCs (HCPCS), FIs (Type of Bill), and QIOs (DRG) |
No Documentation Errors |
| Paid Claims Error Rate |
Projected Improper Payments |
95% Confidence Interval |
/
|
/
|
/
|
/
|
| Non esrd epoetin alpha inj (Q0136) |
10.8% |
$49,232,522 |
( 8.2%) - 29.8% |
| OTHER KIDNEY & URINARY TRACT PROCEDURES |
6.7% |
$28,622,980 |
( 6.3%) - 19.7% |
| Hospital-outpatient (HHA-A also)(under OPPS 13X must be used for ASC claims submitted for OPPS payment -- eff. 7/00) (13) |
0.2% |
$28,575,103 |
0.1% - 0.2% |
| Office/outpatient visit, est (99213) |
0.4% |
$15,452,029 |
0.2% - 0.5% |
| OTHER CIRCULATORY SYSTEM DIAGNOSES W CC |
2.0% |
$14,755,121 |
( 1.0%) - 4.9% |
| Darbepoetin alfa injection (J0880) |
2.9% |
$14,374,622 |
( 2.7%) - 8.6% |
| Clinic-ORF only (eff 4/97); ORF and CMHC (10/91 - 3/97) (74) |
2.6% |
$13,894,302 |
( 0.6%) - 5.9% |
| Subsequent hospital care (99232) |
0.6% |
$13,635,306 |
0.1% - 1.1% |
| OTHER VASCULAR PROCEDURES W CC |
1.1% |
$13,017,029 |
( 1.0%) - 3.1% |
| Psytx, off, 45-50 min (90806) |
5.1% |
$12,670,311 |
( 4.4%) - 14.6% |
| Critical care, add�l 30 min (99292) |
28.0% |
$11,763,048 |
21.4% - 34.6% |
| IV infusion therapy/diagnost (G0347) |
19.2% |
$11,624,345 |
4.8% - 33.6% |
| Subsequent hospital care (99231) |
2.3% |
$10,093,993 |
0.3% - 4.3% |
| Subsequent hospital care (99233) |
0.9% |
$10,057,704 |
0.1% - 1.7% |
| OTHER VASCULAR PROCEDURES W/O CC |
4.6% |
$9,824,843 |
( 4.4%) - 13.7% |
| SIMPLE PNEUMONIA & PLEURISY AGE >17 W CC |
0.3% |
$8,840,686 |
( 0.1%) - 0.7% |
| Initial hospital care (99223) |
1.2% |
$8,471,301 |
( 0.2%) - 2.6% |
| O.R. PROCEDURE FOR INFECTIOUS & PARASITIC DISEASES |
0.6% |
$7,786,211 |
( 0.5%) - 1.7% |
| Extracranial study (93880) |
2.7% |
$7,563,672 |
( 2.4%) - 7.7% |
| Office/outpatient visit, est (99214) |
0.2% |
$6,998,316 |
0.1% - 0.3% |
| Overall |
0.6% |
$1,386,033,725 |
0.3% - 0.8% |
|
|